Sacroiliac joint radiographs taken in three or more views, usually including angled or oblique projections of both joints.
- Medicare
- $38.75
- Work RVU
- 0.22
- Global, days
- Region
- Spine
Documentation requirements
What must appear in the operative or office note to support the claim.
Source · Editorial brief grounded in 3 cited references ↓
- Each view listed (AP, obliques, angled view)
- Indication for a full SI series
- Exam findings supporting SI pathology
- Signed interpretation
- Post-fusion follow-up details when applicable
Applicable modifiers
Modifiers commonly billed with this code.
Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual
What this code covers
Source · Editorial summary grounded in 3 cited references ↓
72202 is the SI joint series with three or more views, typically an AP plus right and left obliques or an angled Ferguson view. Practices use it when they want the joint spaces seen clearly: suspected ankylosing spondylitis, SI degeneration, workup before SI fusion, and follow-up after fusion to check implant position.
Count views from the images actually taken, not the order. If the tech could only get two views, bill 72200. If an AP pelvis was taken and called one of the SI views, the payer may see an overlap with pelvis codes, so do not bill a pelvis film for the same image.
This study covers both SI joints in one unit with no laterality modifier. Rheumatology referrals often need the X-ray before an MRI of the SI joints will be authorized, so a clear report matters downstream. Use TC and 26 when the read and equipment belong to different entities.
RVU & reimbursement
Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.
Source · CMS Physician Fee Schedule, RVU26A · January 2026
Work RVU vs. total RVU
The work RVU (0.22) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (1.16) adds practice overhead and malpractice, and is what drives the Medicare payment below.
| Work RVU | 0.22 |
| Practice expense RVU | 0.92 |
| Malpractice RVU | 0.02 |
| Total RVU | 1.16 |
| Medicare national rate | $38.75 |
| Global period | days |
Payment by site of service
Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.
Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026
| Setting | Medicare rate (national) |
|---|---|
Office (PFS non-facility) Procedure performed in physician's office | $38.75 |
HOPD (APC 5522) Hospital outpatient department | $106.81 |
Common denial reasons
The recurring reasons claims for CPT 72202 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Fewer than three views in the record
- Same image billed as pelvis and SI study
- Laterality modifier added
- No signed interpretation
- Weak diagnosis for imaging
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 3 cited references ↓
01How many views is 72202?
02Do I need SI joint X-rays before an SI joint MRI?
03Is 72202 used after SI joint fusion?
Sources & references
Editorial content was developed using the following public sources.
Mira Scribe
Mira Scribe notes capture the inflammatory back pain history or post-fusion concern behind a full SI series, giving the claim a clear reason.
See how Mira captures CPT 72202 documentation